Most cases of accessory spleen show similar features as normal spleen in imaging studies. However, some accessory spleen has unusual scan feature which can be misdiagnosed. We present a case of intrapancreatic accessory spleen that was discovered incidentally during a workup for abdominal pain in a 47-year-old woman. CT and MRI revealed a different enhancing pattern from that of the spleen. Further evaluation with endoscopic ultrasonography failed to identify the pancreatic mass. Therefore, it was surgically removed and diagnosed pathologically as an accessory spleen.
Diagnostic Errors ; Female ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Pancreatectomy ; Pancreatic Neoplasms/radionuclide imaging/surgery/ultrasonography ; Spleen/*pathology/radionuclide imaging/surgery ; Tomography, X-Ray Computed

PURPOSE: To investigate the clinical manifestations and treatments of parafoveal telangiectasis. METHODS: Twenty-two eyes of fifteen patients diagnosed as parafoveal telangiectasis were selected who had visited Kong Eye Center from September 1999 to August 2003 complaining of decreasing visual acuity. Visual acuity was checked and fluorescein angiography and optical coherence tomography were done. Authors treated six eyes of six patients experienced decreasing visual acuity due to macular edema with argon laser photocoagulation and one eye of one patient accompanying with choroidal neovascularization with photodynamic therapy. RESULTS: Among fifteen patients, group 1 cases were eight (1B eight) and group 2 cases were seven by classification of Gass and Blodi. Visual acuity improved in two eyes of six eyes and maintained in four eyes of six eyes and optical coherence tomography showed decrease of macular edema in six eyes of six patients all after argon laser photocoagulation. Visual acuity improved and optical coherence tomography showed decrease of macular edema in one eye of one patient after photodynamic therapy. CONCLUSIONS: Group 1 cases were more than group 2 cases. Argon laser photocoagulation can be effectively used to treat decreasing visual acuity due to macular edema in parafoveal telangiectasis patients. Photodynamic therapy seems to be effective in parafoveal telangiectasis accompanied with choroidal neovascularization but we think that additional studies with more cases are needed.
Argon ; Choroidal Neovascularization ; Classification ; Fluorescein Angiography ; Humans ; Light Coagulation ; Macular Edema ; Photochemotherapy ; Telangiectasis* ; Tomography, Optical Coherence ; Visual Acuity

PURPOSE: To report two cases of spontaneous resolution of macular hole stage 1 and 2, that were objectively diagnosed with OCT(optical coherence tomography). METHODS: Case 1-A 64-year-old woman without systemic disease visited Kong Eye Center complaining of decreasing visual acuity for 1 month. We diagnosed her case as macular hole stage 1, checked her regularly and detected spontaneous resolution of the macular hole after 6 months. We examined her using OCT before and after spontaneous resolution. Case 2-A 66-year-old man without systemic disease visited Kong Eye Center complaining of decreasing visual acuity for several months. We diagnosed his case as macular hole stage 2 and decided to perform an operation 3 weeks later. On admission, we detected spontaneous resolution of the macular hole. We examined him using OCT before and after spontaneous resolution. RESULTS: We could confirm the spontaneous resolution of stage 1 and 2 macular hole using OCT objectively. CONCLUSIONS: OCT is a useful tool in the diagnosis of macular hole and in the evaluation of various natural course of macular hole.
Aged ; Diagnosis ; Female ; Humans ; Middle Aged ; Retinal Perforations* ; Tomography, Optical Coherence ; Visual Acuity

PURPOSE: To determine the benefit of optical coherence tomography (OCT) in the diagnosis of vitreomacular traction syndrome and evaluate the vitreoretinal interface before and after vitreous surgery. METHODS: Medical records of five patients with vitreomacular traction syndrome who had undergone vitrectomy were reviewed. Preoperative and postoperative visual acuity and preoperative and postoperative OCT were reviewed. In all patients OCT demonstrated posterior vitreous detachment and a focal adhesion of hyaloid membrane to macula with traction on the foveal retinal tissue. All of them underwent pars plana vitrectomy with peeling of poterior hyaloid face. RESULTS: Visual acuity improved in 4 eyes after the first vitrectomy. One eye developed postoperatively a macular hole, which was treated with the second vitrectomy and intravitreal gas tamponade with subsequent improvement in vision. In 4 eyes, OCT showed elimination of vitreous strand, relief of vitreous traction and restoration of normal foveal contour after vitrectomy. CONCLUSION: Optical coherence tomography is a useful tool in the diagnosis of vitreomacular traction syndrome and in the evaluation of status of vitreoretinal interface before and after vitrectomy. Following pars plana vitrectomy, vision improved and normal foveal contour was restored.
Diagnosis* ; Focal Adhesions ; Humans ; Medical Records ; Membranes ; Retinal Perforations ; Retinaldehyde ; Tomography, Optical Coherence* ; Traction* ; Visual Acuity ; Vitrectomy ; Vitreous Detachment

BACKGROUND AND OBJECTIVES: High-resolution computed tomography provides an excellent method for examination of the middle ear, inner ear anatomy and pathologic changes in the temporal bones. The purpose of this study was to get various measurements of the external auditory canal and temporal bones, and to compare the changes with age and sex. MATERIALS AND METHOD: The various measurements by CT of the external ear canal of normal 50 ears were done. RESULTS: The obtained results were as follows: 1) In both male and female group, the distance from the medial end of EAC to bony-cartilage junction, the distance from medial end of EAC to the lateral end of cartilage, the distance from the superior wall to the inferior wall (coronal EAC isthmus) and the distance from anterior wall to the posterior wall (axial EAC isthmus) increased significantly with age (p<0.05). 2) Compared with the female group, the male group had longer distance from the posterior tympanic plate to the sinus tympani with age (p<0.05). 3) Compared with male group, the female group had longer distance from the posterior EAC wall to the Sigmoid sinus and from the EAC superior wall to the tegmen tympani with age (p<0.05). 4) In both male and female groups, the anterior and inferior angles increased and the posterior and superior angles decreased with age (p<0.05). CONCLUSION: Computed tomographic evaluation can give us to information to operate external ear, middle ear, and inner ear surgery.
Cartilage ; Colon, Sigmoid ; Ear ; Ear Canal* ; Ear, External ; Ear, Inner ; Ear, Middle ; Female ; Humans ; Male ; Temporal Bone*

Congenital absence of the major salivary glands, especially of the parotid gland, is a rare disorder whose etiopathogenesis is poorly understood. Aplasia of the parotid glands may be unilateral or bilateral and may occur alone or in association with the absence of other salivary glands or with other developmental anomalies of the first branchial arch, such as hypoplasia or aplasia of the lacrimal glands, hemifacial microsomia, mandibulofacial dysostoses, and multiple congenital anomalies. Various degree of xerostomia and dental caries with early loss of teeth may occur due to decreased salivary production. The authors experienced a case of unilateral parotid aplasia in a 22-year old female who had painless swelling in the right parotid region. We present this case with review of literature.
Branchial Region ; Dental Caries ; Female ; Goldenhar Syndrome ; Humans ; Lacrimal Apparatus ; Mandibulofacial Dysostosis ; Parotid Gland ; Parotid Region ; Salivary Glands ; Tooth ; Xerostomia ; Young Adult

BACKGROUND AND OBJECTIVES: Some patients who have undergone tonsillectomy complain of voice change, but few studies for the mechanism of voice change were found. To solve this problem, study of voice change after tonsillectomy and adenotonsillectomy was done. MATERIALS AND METHODS: We analyzed voice change of 22 patients who underwent tonsillectomy and 15 patients who underwent adenotonsillectomy at CSL (computerized speech laboratory), St. Benedict Hospital. With the measured cross sectional area of vocal tract and its length from the glottis on MR images, we presented the change of cross sectional area schematically after tonsillectomy. RESULTS: Acoustically, the frequencies of the second formant of /e/ and /i/ increased and that of the first formant of /u/ decreased significantly after tonsillectomy and the frequency of the second formant of /o/ and those of the second and third formants of /i/ and /u/ increased significantly after adenotonsillectomy. It was also showed acoustically that the formant bandwidths of /a/ and /hana/ after tonsillectomy and those of /e/ and /hana/ after adenotonsillectomy increased due to nasalization. Anatomically, it was showed that the cross sectional area of oropharyngeal cavity increased and coupling effect of vocal tract happened after tonsillectomy. CONCLUSION: This study showed that acoustic characteristics and vocal tract shapes of the patients did change following tonsillectomy and adenotonsillectomy. It is imperative that we explain to patients about the postoperative voice change. Research should also be done to find ways to induce better voice changes following the operations.
Acoustics* ; Glottis ; Humans ; Magnetic Resonance Imaging ; Tonsillectomy* ; Voice*

PURPOSE: Early diagnosis of foreign body aspiration and removal of the inhaled material may save the patient from chronic illness and may prevent serious complications. At present the diagnostic problems of bronchial foreign bodies are being solved by using the lung scanning technique. Therefore, we investigated the clinical study and diagnositic value of the lung perfusion scan in foreign body aspiration. METHODS: Eighteen cases of airway obstruction due to foreign bodies were treated in the department of pediatrics, Kyung Hee University Hospital. We retrospectively, reviewed patient records to determine the clinical findings, radiologic findings, and findings of the perfusion lung scan. RESULTS: Fifteen cases (83.2%) out of 18 were less than 2 years of age, and the male to female ratio was 1.3:1. Vegetables, especially peanuts were the most common aspirated foreign bodies, and accounted for 72.2% of the cases. Of all foreign body obstructions, 61% were lodged in the main bronchi and there was no significant difference between the right and left main bronchus. In radiologic findings, obstructive emphysema (50%) was most common, followed by atelectasis (33%), mediastinal shifting (23.3%) and pneumonia (22.2%), respectively. There were more severe defects and a higher incidence of abnormalities in cases with prolonged periods after inhalation than that of shorter duration cases. CONCLUSION: Lung perfusion scanning is useful in the diagnosis of foreign body aspiration which presents a vague history of aspiration, insufficient clinical manifestation and normal chest radiologic findings. Our results show that perfusion scan can be helpful particularly in cases of long duration foreign body obstruction.
Airway Obstruction ; Arachis ; Bronchi ; Child ; Chronic Disease ; Diagnosis ; Early Diagnosis ; Emphysema ; Female ; Foreign Bodies* ; Humans ; Incidence ; Inhalation ; Lung* ; Male ; Pediatrics ; Perfusion* ; Pneumonia ; Pulmonary Atelectasis ; Retrospective Studies ; Thorax ; Vegetables

PURPOSE: Lennox-Gastaut syndrome is an intractable epilepsy which is comprised of several types of etiology and generalized seizures. It also combines with mental retardation. The present study was made to ascertain the clinical study on Lennox-Gastaut syndrome in Korea. METHODS: From January, 1985 to December, 1995, 31 children, diagnosed with Lennox-Gastaut syndrome at Kyung Hee University Hospital, were analyzed retrospectively. RESULTS: The ratio of male to female was 2.4:1. With regard to etiology, idiopathic form was found in 7 cases (22.6%) and symptomatic form in 24 cases (77.4%). Transition from West syndrome to Lennox-Gastaut syndrome was observed in 14 cases (45.2%). The most common type of seizure was tonic seizure which was seen in 19 cases (61.3%) and atypical absence, myoclonic seizure and atonic seizure were also observed. The most common clinical signs and symptoms were mental retardation, but others such as progressive loss of psychomotor function and attention deficit were also frequently associated with this syndrome. The EEG usually had abnormal background activity, slow spike and wave complexes and often showed multifocal abnormalities. In spite of intractable epilepsy, 18 cases (58.1%) were controlled with complex anticonvulsant therapy. CONCLUSION: Lennox-Gastaut syndrome manifested itself in children aged 1-6 years and had polyetiology. Most tonic seizures and mental retardation were observed. After complex anticonvulsant therapy with vigabatrin, complete remission was induced in many cases.
Child ; Electroencephalography ; Epilepsy ; Female ; Humans ; Infant ; Infant, Newborn ; Intellectual Disability ; Korea ; Male ; Retrospective Studies ; Seizures ; Spasms, Infantile ; Vigabatrin

BACKGROUND AND OBJECTIVES: The kinds of offending allergens in our environment have changed in accordance with the changes wrought in the living environment. Thus, the study of offending allergens in allergic rhinitis is important. This study attempted to find out annual and seasonal distribution of offending allergens in patients of allergic rhinitis and to investigate the common offending allergens. MATERIALS AND METHODS: A series of allergic skin tests were performed for 3,159 allergic rhinitis patients from Jan. 1981 to Jun. 1990 at the allergic clinic, St.Benedict Hospital, Pusan, Korea, and the results were reviewed. The allergic study included 1) an allergic skin test, 2) a nasal smear for eosinophil. RESULTS: The following summary shows the results of this study: 1) The ratio between male and female of allergic rhinitis patients was 1.15:1 with the peak age being the teens and the twenties (60.6%). 2) The peak season of allergic rhinitis was winter (29.6%), followed by autumn, spring and summer. 3) The common offending allergens were dust and mites (35.9%), pollens (31.2%), epithelials (24.8%). 4) The most common offending allergen was D. farinae (52.5%), followed by D. pteronyssinus, cat fur, Alder pollens and Hazel pollens. 5) 29.6% of patients reacted positive to the skin tests for perennial types of allergens only and 5.2% of patients demonstrated pure pollinosis. CONCLUSION: The most common offending allergen was found to be the dust mite, and the most common pollen was from Alder trees. Perennial types of allergic rhinitis exceeded seasonal types in their occurence.
Adolescent ; Allergens* ; Alnus ; Animals ; Busan ; Cats ; Dust ; Eosinophils ; Female ; Humans ; Korea ; Male ; Mites ; Pollen ; Rhinitis* ; Rhinitis, Allergic, Seasonal ; Seasons ; Skin Tests ; Trees